Laserfiche WebLink
INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> <br />scale: 1" = ~D ' <br /> <br />(show all details and dimensions necessary to locat <br /> <br />all <br /> <br />$~w~=: Size :___~t~ Mat' 1 :~ <br /> Distribution; [~LDrOp / ~ Concrete; [ ] Plastic <br /> Pipe: Size-'~ ~_~;~a,erial: Header:_~_~__. Perf: <br /> <br /> Pump Cycle Time:__~_~a__; Gallons per Cycle: <br /> <br />-- -- North <br /> <br />of the system in the future) <br /> <br />The system was installed by: <br />[ ] Property Owner (permitee) <br />~ Licensed Sewage Disposal Service <br /> <br />(please print] <br /> <br /> (for Marion County use only) <br /> The above septic system has been inspected by Marion County. The information has been determined <br /> to be accurate and the system is: <br /> ]Approved <br /> Approved With corrections: see inspection report <br /> [ ] Denie~ '~~~* ate: <br /> Signed~'' /~ Title ~'~ wD~ P~NK,Installer <br />as-built.frm 4/95 WHITE:Marion County; YELLOW:0 ner; <br />MC-15-S41 <br /> <br /> <br />